12.25.2010

Paris

My room is full of backpacks, messenger bags, duffel bags, matching luggage, tote bags and cases and pouches for things. This has nothing to do with the fact that I'm getting on a plane tomorrow, they've been there for ages. Two of the bags have my travel things, selected from the heap mostly on the basis of current level of cleanliness, memetic or otherwise. The rest are sometimes full, mostly empty, like burned out shells of previous trips.

It'll be weird to not work for so long, probably the most time I've taken off at once since I got my Nursing license. Even during vacation I'm sure I won't be able to help calling in once or twice to see how everyone's doing.

Work has long been my favorite place to be, as surprising as that might sound. With two options for picking up shifts (Hospice in addition to supervising in a nursing home) i've been able to get lots of hours in consistently.

After two years, working as an RN still seems more fun to me than any of the other things around me to do. Maybe fun is the wrong word...it's tolerable. More tolerable to me than the times when I'm not at work. That might sound pathological to some people but to me it just feels like being home.

Home used to be a person, to me..now it's a whole host of people. It's as if years of isolation, estrangement, misunderstanding and doubt were stripped away in the swirling chaos of The Job. The never ending drama of life and death, catastrophe and resolution. Integrity and Despair.

The Job is nearly impossible unless you consider the situation from the patient's point of view. When there's nearly 40 of them you have to consider, no amount of three ring binders or photocopies are going to help you actually understand what's going on with those people. The barriers that people face in their illness or decline can't always be "care-planned" for. Just the simple logistics of the basic care needs for these 40 people is a worthy game in itself, and then the efforts and behavior of subordinates come into play. Complexity upon complexity. Attempting to see one facility simultaneously from the point of view of scores of people sounds like an insane thing to attempt but it's fairly easy to do with the appropriate training. It's hard to do -all- the time, of course, but it's an endeavor that seems like more play than work.

The information involved with The Job could easily fill thousands of 8 1/2"x11" pieces of paper, even more of the documentation is electronic. Every assessment, action, observation, measurement and notation expand exponentially, warped through the lens of billing and insurance. Sometimes it's like some kind of dante's inferno for clerical workers. Keep up with your paperwork while someone's (your, our) grandmother or grandfather is dying in the next room.

To fulfill obscene documentation requirements AND take what you would professionally call "good care" of someone, it's easy to imagine that the job involves a lot of hurry and rushing around. Oddly enough sometimes just offering your time to one of the patients and really talking to them can save you HOURS of work in the coming months. A little planning, care, and thinking ahead (creatively) can save you -effort- as well as time. When it gets to the point where you're -really- on top of things the experience is almost serene, the inevitable emergencies and dilemmas are easy to deal with when everything -else- is in order. One of my mentors back in school told me a story about working on a psych nursing unit, where there would be one person in particular that would rile everyone else up, unless this nurse took an hour out of her busy day to take him aside into a therapy room where he could shout and hit the table all he wanted to, and then the rest of the day was more manageable. Psych's a different milieu, of course, but the idea still holds.


I probably never would have just decided to nip off and flee the continent for a few weeks on my own, but it's probably for the best that I am. Best cure for the holiday blues, surely, is to pack up and exhaust the mind and body with travel. Drown out the memories of holidays past, letters you keep meaning to write, a glimpse of a familiar face walking down the street. Travelling is often fun in the same way Nursing is fun, it's a suitable challenge to the info-maniac pattern-matcher who's bored with anything that can be easily explained or summarized. A perfect distraction for the chronically distracted. In both, sometimes there are quiet moments when there's nothing possible that you can do, and all that's left is to sit and watch. Bask in the sheer improbability of a passing tide of travelers, what a privilege it is to witness this one unique slice on their march towards entropy. A people-watcher's paradise, whether you're watching many people briefly or watching a few very closely and bringing all of your powers of observation to bear in order to make accurate assessments. On a day when everything goes well, everyone works hard and it all falls into place, sometimes there's nothing left for me to do during those last few minutes of my shift. No forms to fill out, no ambulances to greet, just a quiet sit at the nurse's station, staring silently through the front door, listening to the discordant chimes of tragically meaningless alarms. In situations like these I'd only be getting in the staff's way if I hurried around poking my nose in everything. Everyone looks good, all the work is done, all that's left is to greet the next shift when they walk through the door.

Whether I'm home, or travelling, or at work, the place is always the same. Semi-unpacked from a return trip never made. Always at home, and home always slightly out of reach. My aim is the same as it had been, all those years ago, even as far away as it is now. Maybe over the years, they say, and it's too long still, for lives so short and fragile.

Maybe the forces that fling us across continents and augment our memories with overlays and storage devices will somehow let us meet again.

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